1B-04 - Prevalence, Characteristics and Pregnancy Outcomes in Women with Long COVID in the Optum Dynamic Assessment of Pregnancies and Infants Database

Background: Long COVID is associated with symptoms such as fatigue, cognitive dysfunction, respiratory issues and psychological disturbances. According to National Center for Health Statistics, 8.5% of adult women ever had Long COVID and 4.4% currently had Long COVID in 2022. The prevalence of Long COVID in women of reproductive age and its impact on maternal health and pregnancy outcomes is a growing area of research.

Objectives: To evaluate the prevalence of Long COVID and to compare demographics, comorbidities, and pregnancy outcomes in women with and without a diagnosis of Long COVID before pregnancy.

Methods: Using the Optum Dynamic Assessment of Pregnancies and Infants (DAPI) database, we identified a cohort of women with a last menstrual period (LMP) between 01 April 2022 and 31 December 2023. This allowed for approximately 6 months from October 2021, when the ICD-10 code for Long COVID was introduced, until the earliest LMPs in the cohort. We further restricted the cohort to those who had continuous enrollment from 6 months before LMP through pregnancy outcome, were 18 years or older, and had a recorded pregnancy outcome in the database. From this population, we identified women who had a claim for the ICD-10 code for Long COVID (U09.9), during the baseline period (6 months prior to and including the LMP date). We compared women with Long COVID to women without Long COVID with respect to demographic characteristics, pregnancy-related comorbidities, and pregnancy outcomes, and we identified the most common diagnosis codes received one month before to one month after LMP.

Results: Of 133,701 pregnancies beginning during the study period, 185 (0.14%) had a Long COVID diagnosis during baseline. Long COVID diagnosis was more common among pregnant women 35 and older (40.5% vs 28.0%) and in women who had their LMP in 2022 (63.8% vs 44.7%). Commonly recorded diagnoses around LMP among Long COVID pregnancies when compared to pregnancies without Long Covid included cough (9.7% vs 1.9%), asthma (9.2% vs 1.3%), other anxiety disorders (12.4% vs 8.2%), severe stress and adjustment disorders (7.0% vs 3.8%), other joint disorders (7.0% vs 2.7%) and malaise and fatigue (9.2% vs 2.4%). We did not see an increase in pregnancy comorbidities; however, a higher proportion of pregnancies with Long COVID diagnosis were ectopic (5.9% vs 2.7%; p-value < 0.01).

Conclusions: The findings suggest a higher burden of pre-existing conditions and comorbidities in women who became pregnant with Long COVID, thus indicating the importance of comprehensive prenatal care including psychological support for this population. Subsequent analysis will explore healthcare utilization among women with Long COVID and the corelates of the disease in infants through our mother-infant linked database.